A Predictive Strategy for Nonsurgical Management of Pancreatic Stones.
Pancreas
; 53(4): e338-e342, 2024 Apr 01.
Article
in En
| MEDLINE
| ID: mdl-38345918
ABSTRACT
OBJECTIVES:
We set out to predict whether nonsurgical treatment is likely to succeed in removing pancreatic stones in a given patient and also to determine an optimal maximal number of extracorporeal shock wave lithotripsy (ESWL) sessions for treatment of pancreatolithiasis in that patient. MATERIALS ANDMETHODS:
We ascertained the number of ESWL sessions for each of 164 patients undergoing that treatment for pancreatolithiasis between 1992 and 2020. Median follow-up duration was 31 months (range, 0-239), median age was 58 years (22-83), and the male to female ratio was 5.11.0. Patients were divided into 2 groups based upon an optimal maximal number of ESWL sessions determined by receiver operating characteristic analysis.RESULTS:
Total stone clearance was achieved in 130 of 164 patients (79%). The median number of ESWL sessions was 3 (1-61). Receiver operating characteristic analysis determined 7 to be the optimal maximal number of sessions. Complete clearance was more frequent (87%) among the 131 patients requiring 7 or fewer ESWL sessions than among the 33 undergoing more (48%, P < 0.001). Seventeen patients (52%) undergoing 8 or more sessions still had residual stones.CONCLUSIONS:
If any pancreatic stones persist after 7 ESWL sessions, we recommend transition to medical or surgical treatments.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatic Diseases
/
Lithotripsy
/
Calculi
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Pancreas
Journal subject:
GASTROENTEROLOGIA
Year:
2024
Document type:
Article
Country of publication:
United States